Era of life-saving antibiotics could be over if pharmaceutical waste not tackled

Pharmaceutical pollution is contributing to the end of life-saving antibiotics. Despite this a senior European Commission official revealed this week that a much-anticipated EU strategy document on the topic won’t contain any new draft laws.

Pollution from pharmaceutical plants is leading to the development of antimicrobial resistance (AMR) and this in turn could see more and more people dying from previously treatable diseases.

A recent report for the British government claimed that if nothing is done the annual number of deaths globally from AMR could rise from 700,000 to 10 million in the next 35 years.

The comments follow new evidence published by the foundation Changing Markets last week which revealed widespread heavy metal and solvent contamination at factories in Hyderabad, India – a major drug manufacturing hub that produces every tenth tablet sold globally.

Speaking at ‘Joining the Dots’, an event on antimicrobial resistance and pharmaceutical pollution held in the European Parliament on Tuesday , Hans Stielstra from DG Environment said that the Commission’s strategy document – set to be published in May – wouldn’t contain any legislative proposals but that it would look at “all policy options that seem feasible”.

Stielstra, who works on clean water issues, said the Commission was considering measures throughout the product’s lifecycle from dealing with the problem at the manufacturing stage to ‘end of pipe’ solutions such as additional measures at waste water treatment plants. He added:

“We’ll review all policy options all the way from design to final disposal or even reuse where that is possible.”

But Dutch MEP Annie Schreijer-Pierik called for the Commission to put forward legislative proposals to regulate the problem and tackle the consequences of drugs manufacturing and use. She said that the European Parliament has been “waiting in vain” for a strategy on pharmaceutical pollution.

Leonardo Mazza, Senior Policy Officer for Biodiversity and Water at the European Environmental Bureau, pointed to the Commission’s own study from 2013 that demonstrated the need to further regulate pharmaceuticals. He said that “too little had happened” since the study.

Mazza said:

“There is plenty of evidence that Active Pharmaceutical Ingredients (APIs) in the environment pose serious risks to our health and environment. It is an existing well-documented problem without a satisfactory response at EU level. APIs remain the only group of chemicals whose environmental impacts remain largely unregulated at EU level. We need an ambitious and effective regulatory response to be swiftly proposed by the Commission.”

100,000 tonnes of pharmaceutical products are produced globally every year, and while these medicines help to save lives and prevent disease they cause environmental damage both at the manufacturing stage – and when they are excreted by patients through sinks and toilets. With wastewater treatment plants for the most part not adequately equipped to filter pharmaceuticals out, medicines end up having unintended consequences when they come into contact with aquatic life.Recent research from the CHEM Trust showed that human and veterinary medicines are damaging wildlife by polluting rivers and harming wild birds and fish.

As a result of excess amounts of antibiotics used — particularly in intensive livestock farming — and the associated spread of antibiotic resistant bacteria in the environment, the effectiveness of antibiotics is declining. Medical experts have dubbed the phenomenon ‘antimicrobial resistance (AMR) and they warn that if it is not dealt with it could undermine the medical gains of the past century.

Dr Christoph Lübbert from the University of Leipzig said that we are “in danger of falling back into a pre-antibiotic era”.

The European Commission recently published its ‘One Health Action Plan against antimicrobial resistance’ strategy and it has started talks with EU governments and MEPs on new laws on the use of drugs in farm animals. The use of antibiotics in livestock has skyrocketed in recent years, and is a major contributing factor to the rise of AMR globally.

However, Nina Renshaw, Secretary General of the European Public Health Alliance (EPHA), described the Commission’s AMR strategy as “ineffective”. She said it was essential to take on the issues of AMR and pharmaceutical pollution together – particularly given the significant “period of inaction” on the two issues.

She said:

“Scenarios show that if AMR is not tackled it could cause 10 million deaths a year globally by 2050 and could be a bigger killer than cancer. Routine medical procedures that we count on antibiotics to do will be more dangerous.”

Renshaw added that producers have a responsibility for the products they put on the market. She said:

“In line with the polluter pays principle it should be the pharmaceutical sector that bears the cost of introducing these excess pharmaceuticals into the environment.”

Lucas Wiarda, Head of Sustainable Antibiotics Programme at pharmaceutical company DSM-Sinochem, said:

“Ultimately it is on our interest to curb AMR as if antibiotics become ineffective we will have to close our business. When life saving medicine is sold at the price of chewing gum it encourages irresponsible manufacturing and transfers the cost onto society in the form of AMR.”

Recent high-profile reports warn of the dangers of not taking action against AMR. A bleak report by economist Jim O’Neill, commissioned by the British government and released in May 2015, estimated that 700 000 deaths globally could be attributed to AMR in 2015 and that the annual toll would climb to 10 million deaths in the next 35 years.

The Commission’s public consultation on the ‘Strategic approach to pharmaceuticals in the environment’ runs until 21 February.

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